What Does a Registered Nurse Do?

Registered nurses (RNs) are a highly diverse group of professionals who share a common goal: to ease and prevent human suffering due to injury and illness. Modern RNs work in many different roles, from bedside care to patient advocacy to legal consultation. Their efforts ensure that all people have access to the safe, high-quality healthcare they need to live healthy, productive lives.

According to the Institute of Medicine (IOM), RNs make up the largest segment of the nation’s healthcare workforce.

Typical RN duties include:

Serving as frontline providers who monitor and meet patient needs

Working with physicians to deliver well-rounded, responsive care

Educating patients, families and the public

Performing and interpreting diagnostic tests

Operating and monitoring medical equipment

Coordinating care among a team of professionals

Offering emotional support to patients and families

Given the current legislative push toward healthcare reform, the responsibilities of RNs will likely expand in coming years. Under the supervision of physicians, nurses are expected to play a greater role in primary care and the management of complex medical conditions. This shift may help to control rising healthcare costs and could provide better access for people who are currently underserved by the healthcare system.

RNs work in almost all facilities that provide healthcare, including:

Hospitals (most common)

Physician offices

Nursing homes and long-term care facilities

Hospice and palliative care services

Home healthcare agencies

Schools

Community health agencies

Correctional facilities

Not all RNs work directly with patients. In fact, a growing number are found in non-traditional fields such as healthcare administration, informatics, teaching, research and consulting.

Non-clinical nurses work in a wide variety of settings, including:

Health care organizations (in administrative roles)

Private corporations (especially those in the medical field, such as pharmaceutical or equipment companies)

Law firms

Universities

Government agencies

Insurance companies

Consulting firms

Publishers (as medical writers and editors)

About 80% of RNs work full time. Those in inpatient settings typically work rotating shifts that include weekends, nights and holidays. Nurses in outpatient and non-clinical settings are more likely to work regular business hours and are sometimes on call evenings and weekends.

Salary and Job Outlook

State

Average Wage

California

$101750

Texas

$70390

New York

$80830

Florida

$64630

Pennsylvania

$68770

Hover over any state to explore local income and job growth data.

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The Bureau of Labor Statistics reports that the overall median salary for registered nurses is $67,490. The lowest-paid 10% receive a median $46,360 annual salary, while the top 10% earn a median salary of $101,630. Salaries vary by region, workplace, role and experience level. Nurses working in hospitals or outpatient facilities tend to command higher salaries than those who work in doctors’ offices and nursing homes. Earnings generally increase with education, experience and supervisory responsibility.

Employment of RNs is expected to grow by 16% from 2014 to 2024, according to the BLS, which is much faster than average for all occupations. This is largely due to:

A rapidly aging population that is increasing demand for all types of healthcare services

Growing emphasis on prevention within the healthcare industry

Rapid advances in technology and medicine that are creating new treatments and extending human lifespans

The large number of nurses set to retire in the near future

While demand for nurses is expected to increase across all settings, competition is high for positions with regular, daytime hours. A nurse with a bachelor’s degree and clinical experience will continue to have a competitive edge in the job market. Advanced practice nurses will also be in high demand.

Compare Salaries by City

10th Percentile

50th Percentile

90th Percentile

New York City NY Median Pay

$86520 Per Year

$41.59 Per Hour

Los Angeles CA Median Pay

$95940 Per Year

$46.12 Per Hour

Steps to Become a Registered Nurse

1

Earn a degree in nursing.

The first step to becoming an RN is to earn an associate or bachelor’s degree in nursing from a state-approved training program. Alternately, some students pursue a non-degree diploma from a hospital-based program or healthcare system; today this is a rarer and potentially less desirable path, but more on that below.

Associate degrees in nursing (ASNs) take two years to complete and are available through community colleges, career centers and hospital-based programs. Bachelor’s degrees in nursing (BSNs) require at least four years of full-time study at an accredited college or university. Nursing programs cover core classes in English, math and science as well as classroom and practical instruction in nursing. In addition, bachelor’s degree candidates take a variety of classes in the humanities, arts and sciences. Bachelor’s programs also offer upper-level nursing classes on topics such as research and leadership.

A career changer who already holds a bachelor’s degree in a non-nursing discipline is often eligible to enroll in an accelerated BSN or master’s degree (MSN) program. This option is highly intensive and requires a significant time commitment. Most candidates earn a bachelor’s degree in 1-2 years or a master’s in 2-3 years.

2

Complete clinical training and on-the-job experience.

All nursing education programs include extensive, supervised clinical training. In addition, many students work part time as nursing assistants or in related positions to gain on-the-job experience. First-time RNs receive on-the-job training specific to their practice area.

3

Meet state requirements to become licensed.

All RNs must be licensed by the state in which they practice. This requires an associate’s or bachelor’s degree. The minimum education requirement varies depending on the state issuing the RN license. An RN must also receive a passing score on the NCLEX-RN exam administered by the National Council of State Boards of Nursing. Some states have additional requirements such as mandatory training or a criminal background check.

4

Consider promotion possibilities.

Experienced RNs are often promoted to supervisory or administrative roles. Some seek additional education and certification as advanced practice nurses (APRNs) in order to specialize in a field of interest or take on greater responsibility for patient care. Nurses with doctoral degrees often move into research positions or teach at the university level.

Exploring Degree Paths

To sit for the national RN licensing exam (NCLEX-RN), you must graduate from an educational program approved by your state’s board of nursing. This can be a diploma, associate degree, bachelor’s degree, or master’s degree program.

Your state board can provide a list of approved schools. In addition, many states also list the NCLEX pass rates by school. For your board’s contact information, visit the website of the National Council of State Boards of Nursing.

In addition to being state-approved, nursing programs can also pursue voluntary national accreditation. It’s not essential that you attend an accredited program. However, it can make things easier if you later wish to pursue a graduate degree.

DIPLOMA PROGRAM

Diploma RN programs are offered by hospitals and health systems and take about two or three years (depending on how many prerequisites you have completed).

Diploma programs emphasize on-the-job training in a hospital environment. Students also take classes such as:

Nursing fundamentals

Introduces the theory, history, methods, and goals of nursing practice.

Nursing care of the adult

Students apply principles of biology, nutrition, pharmacology, psychology, and mathematics to the care of medical-surgical patients.

Human growth and development

Looks at how people develop physically, intellectually, and emotionally across the lifespan.

Microbiology

Learn to classify, identify, and control tiny organisms like bacteria and viruses.

Diploma programs used to be the most common pathway to RN licensure. They’ve dwindled in number in recent years but remain common in some states.

One drawback of graduating from a diploma program is that you won’t receive a college degree. This can make it difficult to continue your nursing education later. When considering such a diploma program, ask if you will earn any college credits and where these might transfer. Some diploma programs have bridging agreements with local universities that can help you to obtain an associate or bachelor’s degree.

ASSOCIATE DEGREE

2-3 years

Like a diploma program, an Associate Degree in Nursing (ADN) or Associate of Science in Nursing (ASN) takes two to three years to finish depending on how many prerequisites you need. According to the National Organization for Associate Degree Nursing, there are over a thousand ADN/ASN programs at universities, community colleges, and nursing schools across the country.

The big advantage: you’ll graduate with a college degree that can often be applied to your future studies. However, it’s always a good idea to find out where and how many of those credits will transfer. (For example, does the school have a bridging agreement with a bachelor’s or master’s degree program in the area?)

Associate degree coursework is very similar to diploma coursework, but it gets a little deeper into the science and theory of nursing. You’ll study subjects like:

Pharmacology

Learn how drugs affect the body, including concepts like dose, delivery methods, therapeutic effects, and toxicity.

Nutrition

Covers the influence of diet on health, assessment of nutritional status, and diet modification to promote health.

Pathophysiology

How disease affects the body at the cellular and systems levels.

Clinical math

Applies algebra and general math principles to problems like medication dosage and fluid administration.

ADN/ASN programs also include extensive clinical experience caring for patients under supervision.

BACHELOR'S DEGREE

4 years

There are a couple of good reasons to consider a bachelor’s degree in nursing.

First, the profession is moving in this direction. In 2010, the Institute of Medicine called for 80 percent of nurses to hold a BSN by 2020. Employers are following suit and increasingly prefer to hire bachelor’s-level RNs. The number of BSN programs is increasing in response to demand from the healthcare industry.

A four-year degree can also expand your career opportunities. For example, it will let you move into specialties like cardiac rehab, public health, case management, and school nursing, all of which have high education standards.

BSN coursework delves deeper into specific areas of nursing like mental health, community health, chronic disease, and pediatrics. You’ll also gain a big-picture understanding of how the healthcare system works and how economics, politics, social justice, and other factors influence our health. There’s also room in the schedule for elective courses in non-nursing subjects that interest you.

Informatics

Learn to use computer systems and applications to foster better patient care.

Some schools offer specialized bridge programs that help a licensed practical nurse (LPN) or a nurse with an associate degree to pursue a bachelor’s or graduate degree. In many cases, these programs award credit or waive prerequisites based on a candidate’s prior education and work experience. Bridge programs take 1-4 years to complete depending on the candidate’s education level and target degree.

Additionally, students who already hold a bachelor’s degree in a non-nursing field may be eligible for an accelerated or second-degree BSN program. This can qualify you to sit for the NCLEX in as little as three semesters.

MASTER'S DEGREE FOR NON-NURSING MAJORS

6 years (2 years in program)

If you already hold a bachelor’s degree in a non-nursing field, a Master of Science in Nursing (MSN) is probably the fastest pathway to becoming an advanced practice nurse, clinical nurse specialist, nurse researcher, or professor of nursing.

Once you earn your MSN degree and pass the NCLEX, you’ll be eligible to pursue certification as an advanced practice nurse or clinical nurse specialist. This typically requires additional classes and clinicals.

Keys to Success as an RN

Necessary Skills and Qualities

Critical thinking

Aspiring RNs should be critical thinkers. They must be able to spot a problem and use sound reasoning to solve it.

Communication

RNs need to be excellent communicators. They will have to listen carefully and speak clearly to patients as well as fellow staff members in order to carry out tasks successfully.

Health consciousness

Because they spend long periods on their feet and are called upon to lift patients, candidates should be in good health and physically fit.

People skills

Emotional stability, compassion and patience will help them to work effectively with challenging patients and family members.

Teamwork skills

Finally, future RNs should be team players who will enjoy collaborating with nursing colleagues and other healthcare professionals.

Additional Credentials

Just about every healthcare specialty offers certification for practicing RNs. Candidates must meet experience and education requirements and pass an assessment. Some common examples include:

The American Nurses Credentialing Center offers board certification for RNs in a variety of specialties. Candidates must be licensed RNs. Education and experience requirements vary by credential. Assessment is by exam or portfolio.

Popular Degree Programs

Related Career Paths

Authored by:

Holli Sowerby, EdD, RN

Holli Sowerby EdD, RN is an assistant professor of nursing at Weber State University. Her research interests include the perceptions of graduates regarding laboratory simulation experiences and the effectiveness of simulation.